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Abstract
This paper uses data abstracted from 465 client records randomly selected from the current files of a downtown medical clinic in Chicago, Illinois to examine substance use among 85 immigrant and 380 nonimmigrant homeless and “at-risk” homeless adults. Immigrants to the United States reported lower levels of current cigarette, alcohol, and drug use compared to nonimmigrants in the sample. Immigrants were also less likely to report potential substance user treatment needs. Immigrants, however, did not differ from nonimmigrants in the reported quantity or frequency of cigarette and alcohol use. Drug use among homeless immigrants was also higher than estimates of misuse in the general population. The literally homeless in the sample reported higher levels of substance use compared to “at-risk” homeless. The literally homeless were also more likely to report higher levels of consumption and were more likely to have potential substance user treatment needs. The role of stress in the etiology of substance misuse among homeless immigrants and nonimmigrants is discussed. Implications for the treatment of these diverse populations are also addressed. [Translations are provided in the International Abstracts Section of this issue.]